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Reading this debate and watching the coverage from the UK has been fascinating and, at times, troubling.

I was diagnosed HIV+ about 8 weeks ago. Having researched this, I'm confident that I'm benefiting from advanced treatment. I've suffered no delay and have been handled with sympathy, respect and dignity.

My local doctor, Accident and Emergency services, NHS Direct (a non-emergency, medical, 24 hour, telephone helpline available to all), the STD clinic that provided my initial test and the specialist HIV clinic where I'm treated have all provided me with outstanding service and support. No one asks me for money when I arrive or sends me a bill after. They just treat me according to my need. I pay tax on my income but if I were unemployed, earning less or earning more, I'd still be treated the same.

It's now 23:30 in the UK and time for me to take my daily dose of Atripla. If I had to pay for this, I believe it'd cost me the equivalent of $50 USD/day ($18,000/year). Thankfully, I don't. Knowing that so many lack what I take for granted is why I'm troubled. Compared to most, I'm spoilt.

I believe that lady in the town hall was part of the Lyndon LaRouche gang. They always try to link Obama to Hitler. They are a pretty nutty group of nutjobs. I think there also is a link to the John Burch Society and the Lyndon LaRouche followers. Both groups believe in some crazy ideas, just enough to be dangerous. If Im not mistaken, their people are also the ones bringing-wearing the guns to Obama healthcare events. These are the people the NRA protects.

There is no reason and no real connection to reform and these crazies coming out of the woodwork.Its just their chance to take advantage of an opportunity. Obama, a black president and government. Both of which they will not tolerate.Its not healthcare, its just their chance to wear guns in public, and link Obama to Hitler, in protest of their anti government beliefs. Actually, it goes back to Reagan. Not the 1980's Reagan, but the 1960's Reagan "American Medical Association" spokesman.

The lady at the town hall, guns in public, the John Burch Society, the Lyndon LaRouche gang and the 1960's Reagan. They are all linked. And dare I say.... many republicans. At least... many republicans, and the Rush Limbaugh's, have found an odd-fellow relationship. The Lyndon LaRouche gang can use the town halls as an outlet, and the republicans welcome the anti Obama policy ranting.This odd fellow relationship is very dangerous for the republicans to align themselves with.If it backfires, and it will, that could destroy the republican party as we know it.

When will we see it implemented at least the issue of eliminating the pre existing condition clause ?

The health care bills from the Senate and the House must be combined for a final bill but what I read of the one in the Senate is that pre-existing conditions exclusions affecting children would be eliminated immediately after the bill passes but for adults it would not take effect until 2014!

Which is a CROCK. Just another of those ridiculous concessions allowing insurance companies to continue to act unethically for longer.

The health care bills from the Senate and the House must be combined for a final bill but what I read of the one in the Senate is that pre-existing conditions exclusions affecting children would be eliminated immediately after the bill passes but for adults it would not take effect until 2014!

Which is a CROCK. Just another of those ridiculous concessions allowing insurance companies to continue to act unethically for longer.

We'll see what it will be when there is a final bill.

Note, the Senate bill delays some provisions until the new insurance exchanges are set up (in 2014 under the Senate bill). But in the meantime there are usually some programs to fill in some or all of the gap. For adults with preexisting conditions the Senate bill sets up a new temporary program immediately that runs until 2014:

Sec. 1101. Immediate access to insurance for people with a preexisting condition. Enacts a temporary insurance program with financial assistance for those who have been uninsured for several months and have a pre-existing condition. Ensures premium rate limits for the newly insured population. Provides up to $5 billion for this program, which terminates when the American Health Benefit Exchanges are operational in 2014. Also establishes a transition to the Exchanges for eligible individuals.

And, as a historical comparison, Social Security did not pay benefits immediately on date of enactment either. In fact, as first enacted (in 1935,) it would have paid its first benefits in 1942. It was later amended to make its first payments in 1940. Revenue offsets (e.g. taxes) started in 1937 however.

What does that mean? I wondering if they'll ever give us any specifics on premium rates... or if we'll end up with the insurance companies deciding what is and what is not too expensive based on their expected payout.

What does that mean? I wondering if they'll ever give us any specifics on premium rates... or if we'll end up with the insurance companies deciding what is and what is not too expensive based on their expected payout.

It means that limits are placed on the design of the insurance policy (the maximum out of pocket payment, no benefit limits, etc.), insurance company profits (minimum percentage of premiums that must be paid as benefits), premium disparities (only age-related variation in premiums) ...

But no, the federal government is not going to specify premium amounts. This bill reforms the health insurance marketplace; it does not replace the private market with a public plan. It gets us to a dramatically better place, but not by any means a perfect one.

And, as a historical comparison, Social Security did not pay benefits immediately on date of enactment either. In fact, as first enacted (in 1935,) it would have paid its first benefits in 1942. It was later amended to make its first payments in 1940. Revenue offsets (e.g. taxes) started in 1937 however.

Ummm... the Social Security numbering system was started by 1937, when taxes were collected.

But even more to the point I was making, major new programs generally have some delay built in because getting something new right takes time. The specific challenge varies, but it is common for there to be a delay. And it is common for the programs to collect revenue (taxes) before the benefits kick in. This is not some new, deadly, unheard of left-wing/right-wing plot; it is how the legislative process typically works.

In this case the major new hurdle is the set up of the insurance exchanges which will reflect an enormous change in the rules of the road for insurers. And since those rules will never be set out in more than outline form by Congress, the details of those rules will have to be set out by federal regulators (who currently do not regulate health insurance; currently health insurance regulation is almost entirely by the states). Under the due process rules for federal regulations, the new regulators will have to propose rules, accept comments, possibly hold hearings and then publish final rules or re-propose and start the process all over again. Then the insurers and the exchanges will need to go through all the insurance policies they have and amend them -- states will often still need to sign off on the changes. This all takes time, lots of it. A huge advantage of merely extending Medicare to all would have been the timeline savings from not needing to invent new wheels. But politics is the art of the possible...(sigh)

First application forms were distributed in late November 1936. The numbers were assigned in the local post offices. After Social Security numbers were assigned, the first Federal Insurance Contributions Act (FICA) taxes were collected, beginning in January 1937.

But even more to the point I was making, major new programs generally have some delay built in because getting something new right takes time.

Some aspects of new legislation take time to implement but declaring that pre-existing conditions no longer apply is not something that would take time to implement. They "compromised" (at least in the Senate, not sure what the House bill says about this) that children are exempt immediately but adults have to wait until 2014. This was a concession to benefit the insurance companies at the expense of the lives and health of average Americans.

What does that mean? I wondering if they'll ever give us any specifics on premium rates... or if we'll end up with the insurance companies deciding what is and what is not too expensive based on their expected payout.

My understanding is, regardless of premiums, an individual is only required to spend less than 10% of their income on healthcare, and a family of four making roughly no more than $80,000 a year, or 400% of the poverty level would qualify for subsidies.